Knowledge, attitude, prevention practice and lived experience towards cutaneous leishmaniasis and associated factors among residents of Kutaber district, Northeast Ethiopia, 2022: A mixed method study.

Background: Cutaneous leishmaniasis is a widespread parasitic infection in Ethiopia. Few studies have been conducted on knowledge, attitudes, and prevention practice related to cutaneous leishmaniasis, and the existing studies have been mainly without qualitative support. This study aimed to assess the knowledge, attitude, prevention practice and lived experience towards cutaneous leishmaniasis and associated factors among residents of the Kutaber district, Northeast Ethiopia. Methods: A convergent parallel mixed method was conducted among 636 residents (for quantitative) and 20 in-depth interview participants (for qualitative) of the Kutaber district from July 1 to August 15, 2022. Quantitative data were entered into Epi-Data version 4.6 and exported to SPSS version 25 for cleaning and analysis. ATLAS.ti software version 8.0 was used for the analysis of qualitative data. Results: The survey respondents in Kutaber district showed good knowledge (47.5%), a positive attitude towards (54.1%) and a good prevention practice (35.3%) regarding cutaneous leishmaniasis. Residents who were unable to read and write [AOR = 0.15] had lower odds to have good knowledge about cutaneous leishmaniasis. Residents aged >54.5 years [AOR = 0.33] had lower odds to have a positive attitude towards cutaneous leishmaniasis. Males [AOR = 1.76] had a good prevention practice towards cutaneous leishmaniasis. Five main study themes were formed following the qualitative analysis of the data. Conclusion: Residents of Kutaber district have a poor overall knowledge and prevention practice towards cutaneous leishmaniasis, despite having a positive attitude. The educational status of residents and years of residence were factors significantly associated with knowledge about cutaneous leishmaniasis. Age and years of residence were factors significantly associated with attitude towards cutaneous leishmaniasis. Gender, age, and household wealth were factors significantly associated with prevention practice towards cutaneous leishmaniasis. Cutaneous leishmaniasis in Kutaber is a true health problem. Author summary: Cutaneous leishmaniasis (CL), a prevalent disease caused by an intracellular protozoan transmitted by a vector, is a serious public health issue, particularly in Kutaber district, where it causes significant physical and psychosocial problems among the residents. Even though it is not fatal, cutaneous leishmaniasis can lead to complications, lifelong scar and disfigurement, resulting in social isolation and discrimination. We showed that this is strongly associated with the district residents' poor knowledge and prevention practice towards the disease. Cutaneous leishmaniasis, a true health problem of the community, is worsened due to limited efforts of healthcare professionals, limited roles played by the media in health information communication, budget problem, low attention given from the government, lack of information dissemination, and lack of awareness. This implied that there is a need of rigorous provision of health education on the cause, transmission mechanism, intermediate host, breeding site, sandfly vector, treatment and implementation of prevention strategies. [ABSTRACT FROM AUTHOR]